Relationship Between The Pre-Treatment HALP、NLR、LMR And Progression-Free Survival In Patients With Advanced Non-Small Cell Lung Cancer Without A Driver Gene

ObjectiveThis study evaluated the prognostic value of hemoglobin and albumin levels and lymphocyte and platelet counts(HALP),neutrophil-lymphocyte ratio(NLR),and lymphocyte-monocyte ratio(LMR)in patients with advanced driver-negative nonsmall cell lung cancer(NSCLC)before administered chemotherapy.MethodsThis study retrospectively collected clinical case data from 81 patients who met the inclusion criteria at The First People’s Hospital of Foshan from January 2012 to December 2021.This population was all patients with a first diagnosis of advanced unresectable driver-negative non-small cell lung cancer administered first-line platinum-based chemotherapy.The best cut-off values of pre-treatment HALP,NLR and LMR scores were calculated using X-Tile software version 3.6.1,and the patients were divided into low-HALP and high-HALP groups,low-NLR and high-NLR groups,and low-LMR and high-LMR groups;clinical measures were collected using the mean±standard deviation,and inter-group comparisons were made using the independent sample T-test,and comparisons of count data were performed using the chi-square test.The Kaplan-Meier method was used to plot the survival curves for progression-free survival(PFS),and the Log-rank test to evaluate statistical significance.Cox regression models were used for univariate and multivariate analyses to assess prognostic factors in patients with advanced driver-negative non-small cell lung cancer treated with chemotherapy.ResultsThe best cut-off value of HALP score was 42.8,70 cases in the low HALP group(<42.8)and 11 cases in the high HALP group(≥42.8),the best cut-off value of NLR score was 1.9,11 cases in the low NLR group(<1.9)and 70 cases in the high NLR group(≥1.9),the best cut-off value of LMR score was 2.1,26 cases in the low LMR group(<2.1)and 55 cases in the high LMR group(≥2.1).the high and low HALP scores were not correlated with gender,age,smoking history,body mass index(BMI),pathology type,TNM stage,and chemotherapy course(P>0.05);the high and low NLR scores were not correlated with gender,age,smoking history,BMI,pathology type,and TNM stage(P≥0.05),and the high and low NLR scores were correlated with chemotherapy course(P<0.05);the high and low LMR scores were not correlated with smoking history,BMI,pathology type,TNM stage,and chemotherapy course(P>0.05),but the high and low LMR scores were correlated with gender and age(P<0.05).KM analysis showed that the PFS was statistically different from the low HALP group and high HALP groups(P=0.044),PFS was not statistically different between the low NLR and high NLR groups(P=0.071),and PFS was statistically different between the low LMR and high LMR groups(P=0.017).Univariate analysis showed that gender and LMR were associated with PFS in NSCLC patients receiving platinum-containing twodrug chemotherapy(p<0.05);multivariate analysis showed that gender and LMR were independent prognostic factors in driving gene-negative NSCLC,with PFS risk ratios of 1.747(95%CI:1.046-2.920),1.783(95%CI:1.104-2.880),p=0.018).ConclusionIn patients with advanced driver gene-negative NSCLC treated with platinumbased chemotherapy,HALP score may be predictive of first-line chemotherapy efficacy;LMR is an independent prognostic factor for driver gene-negative NSCLC,and low level of LMR value suggests a short PFS and poor prognosis for first-line chemotherapy in NSCLC;NLR score is not a predictor of PFS for first-line chemotherapy in patients with advanced driver gene-negative NSCLC.